Medicine and the Seven Deadly Sins in Late Medieval Literature and Culture by Virginia Langum (review)

Virginia Langum has an ambitious agenda in Medicine and the Seven Deadly Sins in Late Medieval Literature and Culture. She attempts to provide a thorough overview of the medical contexts for the Seven Deadly Sins, of the status of each sin in relation to medieval theories of the body and the passions, and of the material effects of the sins upon the entirety of the human, body and soul. She also aims to study this subject matter not only as regarded by the theologians of the late classical and medieval periods (especially 1215–1500), but also as treated by writers both in high and low cultural literary contexts, both in Latin and in the vernacular. The inclusion of sermon and pastoral literature is especially noteworthy. The one concession that Langum makes to narrowing the scope of her study is the choice to focus upon medieval England, where the practice of medicine differed in several respects from that on the Continent.

As Langum points out in the Introduction, the concept of the Deadly Sins dates back to fourth-century monasticism, but it has gone through many permutations since then. The list perhaps familiar to readers today—pride, envy, wrath, avarice, sloth, gluttony, and lechery—was not always the order, the number, or even the sins included on the list. What a sin involves likely has changed, too. More fixed has been the distinction between sin and vice: "Whereas a sin describes an act, a violation of God's law, a vice describes embeddedness: a behavioral pattern" (13). The period 1215–1500 was the high point of emphasis upon the Deadly Sins. For concise articulation of moral behavior, they slowly gave way to an increased focus upon the Ten Commandments, although the Sins never disappeared and they remain cultural constructs to this day.

1215 is also a significant date in the history of medicine, marking the start of its secularization as a profession in the West. The Fourth Lateran Council held in 1215 significantly restricted the range of medical procedures clerical practitioners could perform, making it difficult for churchmen to function either as physicians or especially as surgeons. The Council also famously "decreed that every physician of the body must call for a physician of the soul before beginning any treatment" (10). But Langum points out that medicine and religion did not exist in opposition to each other in the medieval period. From an understanding of the composition of the human body to approaches to its cure, Langum demonstrates the inseparable intertwining of the medical and the spiritual in the premodern period. This intertwining is evident in how moral behavior was medicalized and how medicine was moralized.

Langum begins her study by sketching the relevant historical background of medicine and religious thought, carefully outlining key terms and concepts unfamiliar to modern readers. In a general introduction to "Medicine, Sin and Language," she notes the important image of Christus medicus (Christ the healer) and then explains her methodology as a three-fold examination of each medicalized sin in terms of metaphor, metonym, and material. Each sin is introduced and considered in turn in its own chapter. For example, in Chapter Six, Avarice is introduced by questioning the motive for this vice. "Is it a sin of the spirit or of the flesh?" (133), Langum asks. John Chrysostom, Thomas Aquinas, Alexander of Hales, and Richard of Lavynham's Litil Tretys are considered for their perspectives on this question. The overlapping concepts of avarice, covetousness, and greed are touched upon, Chaucer's definition in the Parson's Tale is mentioned, and the seven other species of avarice articulated by Gregory the Great are listed. As medical metaphor, avarice is persistently associated with dropsy (water retention, edema) because dropsy was thought to cause extreme thirst. Augustine of Hippo and Gower's Confessio Amantis are cited...